§ Paul FlynnTo ask the Secretary of State for Health what measures he plans to introduce to reduce deaths caused by the mis-use of(a) painkillers and (b) anti-depressants. [2368]
§ Yvette CooperThe Department introduced specific measures in September 1998 reducing pack sizes of paracetamol and aspirin aimed at reducing the toxicity from impulsive overdose. New warnings on the packaging emphasised the risks and action to take in the event of overdose. Recent published studies on the impact of these measures have provided evidence that they are having a significant beneficial effect.
The majority of deaths in association with antidepressants are as a result of suicide. We take the issue of suicide very seriously. We are currently developing, under the direction of the National Director for Mental Health, Professor Louis Appleby, a coherent, national suicide prevention strategy to ensure that we are doing all we can to prevent suicide.
Advice is given to health professionals in British National Formulary, which advises that patients treated for depression should be assessed frequently for suicidal tendencies and that limited quantities of antidepressant drugs should be prescribed at any one time to reduce the 346W risk of overdose. The summaries of product characteristics for antidepressants warn that patients at risk of suicide should be monitored closely.
§ Paul FlynnTo ask the Secretary of State for Health what progress has been made in(a) identifying and (b) reducing the levels of (i) mis-use and (ii) over-use of neuroleptic drugs in residential homes for the elderly. [2369]
§ Jacqui SmithData on the misuse or overuse of neuroleptic drugs are not available centrally. However, we are well aware of concerns about the use of these drugs in older people. Several current initiatives will help to address this issue.
The National Minimum Standards for Care Homes for Older People, published in March 2001 under section 23(1) of the Care Standards Act 2000, contains a standard for the administration of medicines. This includes requirements to take advice from pharmacists, consult general practitioners and regularly review medication. These standards come into force in April 2002.
The National Service Framework for Older People was also published in March, together with 'Medicines and Older People', covering the implementation of medicines related aspects of the NSF. One of its aims is to ensure that older people gain maximum benefit from their medication and do not suffer unnecessarily from illness caused by excessive or inappropriate consumption of medicines. One of the milestones set in the NSF is that, by April 2002, people over 75 will have their medicines reviewed at least annually, and those taking four or more medicines will have a review six-monthly. And, by 2004, every primary care trust (PCT) will have schemes in place so that older people get more help from pharmacists in using their medicines.
Finally, the NHS Plan contains a target that repeat dispensing schemes will be in place nationally by 2004. Together with management of repeat prescribing commissioned locally by PCTs, these schemes will provide further help in avoiding medication problems in older people.
§ Paul FlynnTo ask the Secretary of State for Health what estimate he has made of the percentage of those who use(a) heroin and (b) methadone under medical prescription who have died in each of the past five years. [2373]
§ Yvette CooperThe information requested is not available centrally in the form requested.
The Departments collects information relating to the number of dispensed in the community in England (which includes prescriptions for diamorphine and methadone) but there is no means of identifying whether the recipient of the prescription subsequently dies.
Information about all deaths in England and Wales in 1995 to 1999 where the underlying cause of death is regarded as resulting from drug-related poisoning is included in the Health Statistics Quarterly report, published by the Office for National Statistics in spring 2001. The report also contains information about the number of deaths where selected substances, including heroin and/or morphine and methadone, were mentioned on the death certificate.
347WThe table shows the numbers of deaths where heroin and/or morphine and methadone were mentioned on any death certificate and are regarded as resulting from drug-related poisoning from 1995 to 1999. The figure is given for heroin and morphine combined because heroin breaks down in the body into morphine, and the latter may be detected at post mortem and recorded on the death certificate.
Number of deaths where heroin and/or morphine and methadone were mentioned on the death certificate for England and Wales Drug mentioned Year All mentioned of heroin and morphine Methadone 1995 357 310 1996 466 368 1997 445 421 1998 645 363 1999 754 298 Note
These figures do not include deaths where heroin, morphine and methadone were not mentioned on the death certificate, but were a causal factor; or where these substances were prescribed, but were not a causal factor in the death and so are not mentioned in the death certificate.